NHS Scotland to institute cost sharing? Pause access to new drugs?

That is according to an article today from the BBC.

NHS leaders in Scotland have discussed abandoning the founding principles of the service by having the wealthy pay for treatment.
The discussion of a “two-tier” health service is mentioned in draft minutes of a meeting of Scotland’s NHS leaders in September. They also raise the possibility of curtailing some free prescriptions.

Part of the rationale for considering this move are a large budget hole and many staff positions going unfilled.

Last month the BMA in Scotland said the country’s health service was in a “perilous situation” and urgent action was needed to tackle work load pressures. Official figures show about 6,000 nursing and midwifery posts are unfilled while A&E waiting time targets continue to be missed.

The move is particularly controversial due to some of NHS’s founding principles, but

The NHS was established on 5 July 1948 after Labour Health Secretary Aneurin Bevan promised “a universal health service without any insurance qualifications of any sort…available to the whole population freely”.

But controversial charges for dental and eye care were introduced within three years, contributing to Bevan’s resignation from the government.

In recent years health services across the UK have been beset by immense challenges including the Covid pandemic, an ageing population and staffing shortages.

Some of the moves considered would be highly draconian and could include:

An option to “Pause funding of new development/drugs” unless they can be proved to save the NHS money…
Stopping care services altogether and instead sending patients home for care

The discussion concludes by saying:

“The fundamental model of healthcare is not working for us.”

With NHS Scotland facing multiple challenges, the question may be less “if” NHS Scotland will change, but rather “how” it will change.